Low-dose dapsone prophylaxis of Pneumocystis carinii pneumonia in AIDS and AIDS-related complex.
The efficacy, toxicity and cost of orally administered dapsone (50-100 mg/day) for prophylaxis of Pneumocystis carinii pneumonia (PCP) were evaluated in 30 patients with AIDS or AIDS-related complex (ARC). Six patients received primary and 24 secondary prophylaxis. Ten patients received a maximum dose of 100 mg/day and 20 a maximum of 50 mg/day for a median duration of 19 weeks; 22 of the 30 patients continue to receive prophylaxis as of May 1989. Four patients have died, none of pneumocystis infection. One patient with AIDS suffered a mild relapse while receiving 50 mg/day. Hematologic toxicity was mild and could not be definitively attributed to dapsone therapy; rash due to dapsone was documented in two patients. A review of 33 patients at our institution with a history of PCP who received no prophylaxis demonstrated seven relapses, three of which were fatal. Cost analysis revealed a significant advantage for oral dapsone over aerosolized pentamidine.
Kemper
C A
CA
Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128.
Tucker
R M
RM
Lang
O S
OS
Kessinger
J M
JM
Greene
S I
SI
Deresinski
S C
SC
Stevens
D A
DA
D000386:AIDS-Related Complex / Q000150:complications*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000284:Administration, Oral; D000328:Adult; D003365:Costs and Cost Analysis; D003622:Dapsone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000191:economics / Q000517:prevention & control*
D003622:Dapsone